- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.28 / $17.98 / $51.96
| Facility | | $7.28 | $17.98 | $51.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.78 / $8.32 / $9.63
| Professional | | $5.78 | $8.32 | $9.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.69 / $6.69 / $6.69
| Professional | | $6.69 | $6.69 | $6.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.89 / $31.24 / $57.68
| Facility | | $11.89 | $31.24 | $57.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.00 / $5.50 / $8.57
| Professional | | $5.00 | $5.50 | $8.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.74 / $9.63 / $14.45
| Professional | | $6.74 | $9.63 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.67 / $8.67 / $9.63
| Facility | | $8.67 | $8.67 | $9.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.73 / $21.16 / $48.92
| Facility | | $6.73 | $21.16 | $48.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $7.04 / $16.41
| Professional | | $5.09 | $7.04 | $16.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.57 / $116.45 / $116.45
| Facility | | $61.57 | $116.45 | $116.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.70 / $9.63 / $12.52
| Facility | | $7.70 | $9.63 | $12.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.17 / $9.63 / $12.55
| Professional | | $9.17 | $9.63 | $12.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.70 / $9.63 / $26.59
| Facility | | $7.70 | $9.63 | $26.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.09 / $7.40 / $13.79
| Professional | | $5.09 | $7.40 | $13.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $5.51 / $8.91
| Professional | | $4.04 | $5.51 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.76 / $4.76 / $9.63
| Professional | | $3.76 | $4.76 | $9.63 |